Female Fertility: What’s Testosterone Got To Do With It?

The use of testosterone to improve outcomes in women undergoing in vitro fertilization is taking hold across the country, but data on its use is slim and mixed. Some clinical trials support the use of testosterone given through the skin, while others have shown no benefit of the supplement DHEA (which is converted by the body into testosterone) in increasing pregnancy and birth rates.

A new study suggests that male hormones might actually be doing something good for female fertility.

Published in the Proceedings of the National Academy of Sciences, the study suggests that male hormones, also called androgens, help drive the development of follicles – structures that contain and ultimately release an egg that can be fertilized by a man’s sperm. The research also details how male hormones boost the production of follicles in mice.

Study authors, led by Stephen R. Hammes, M.D., Ph.D., professor of Endocrinology at the University of Rochester School of Medicine and Dentistry, believe their research provides potential biological targets to enhance fertility in women with diminished ovarian reserve, who produce few or no follicles in response to IVF drugs designed to boost follicle development.

Kathleen M. Hoeger, M.D., M.P.H., director of UR Medicine’s Strong Fertility Center, estimates that around 20 percent of the patients her team treats have diminished ovarian reserve, meaning they produce fewer follicles than estimated based on their age. Women who are 40 years or older are most likely to have diminished ovarian reserve, but it can appear in younger women as well.

Hammes says the study calls for further clinical trials to determine whether androgens can have a positive effect on fertility when given at the right doses. And, by better understanding the biological pathways that are important for follicle development, scientists may be able to target these pathways with drugs or other interventions to improve IVF success rates.

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